Housing First: Is it an answer to complex social issues?

The recent excellent journalism of Sarah Day, Michael Penn and Courtney Nelson in documenting not just Juneau’s issues with chronic inebriation, but also the issues faced by the people behind the problem, brought an interesting idea to the forefront — Housing First.

Housing First, put simply, would provide safe, permanent living space for people who cannot obtain housing on their own, for whatever the reason.

While residents would be subject to certain conditions — no fighting and room maintenance, for instance — one condition they would not be subject to is mandated sobriety. That idea flies in the face of many existing solutions for people who would otherwise be homeless, as they make sobriety, or at least an honest effort at it, a requirement. The Glory Hole, for instance, requires its patrons to be sober to receive services, putting that policy in place after a small number of intoxicated folks caused a large number of problems at the downtown shelter and soup kitchen.

Given that experience — and the understandable feeling that providing housing for alcoholics without requiring them to at least try to address their problem is enabling that behavior — it may seem counterintuitive to propose a housing solution for homeless chronic inebriates that allows drinking. But there are at least two reasons the idea needs to be examined.

First, the reasons people become chronic inebriates are varied and complex. Some simply started drinking without realizing their brains and bodies lack the capacity to stop after one or two, for reasons that medical professionals still don’t fully understand. Others suffer from undiagnosed or untreated mental health issues, and use alcohol — among other drugs — in an effort to medicate themselves.

Given these issues are complex and can take years to understand and figure out, it’s hard to imagine a person dealing with those problems being able to dedicate the effort and energy it takes to address them when more basic questions (Where will I sleep? Will I be safe? Where can I put my belongings so they won’t be stolen?) dominate his or her daily life.

Housing First would help people answer those most basic questions of daily survival, hopefully clearing the way for them to address the more complex issues about their health and well-being.

A Housing First complex would also make those resources available on-site, so people who are ready to deal with their problems can do so more easily.

Some estimates state Juneau’s homeless population is as high as 600 people. Of course, not all of those people have substance abuse issues, but those that do face them are increasing the amount of time and money Juneau has to spend on law enforcement, public safety and health care. The Housing First model can address that. A facility in Seattle dropped per-person public expenditures from $4,000 a month to less than $1,000 — or a savings of $4 million a year — according to an article in the Spring 2010 edition of the Alaska Justice Forum. In that studied timeframe, residents of Seattle’s Housing First facility “drank less over time, had fewer visits to the hospital emergency room and jail, and spent fewer nights at the homeless shelter or sobering center,” the article states. Of course, Juneau isn’t Seattle, but it is interesting to note Rochester, Minn., a town a bit bigger than 100,000 people, is creating such a place.

While that’s still a city more than three times Juneau’s population, it shows this concept is growing out of its big-city roots and taking hold in smaller and smaller communities. As Juneau grows, its issues with both homelessness and chronic inebriation will grow as well, and it would be a good idea to have solutions in place before the problems grow larger and harder to manage.

It’s easy to argue Juneau should not be offering free or low-cost housing to homeless people — many with substance abuse problems — when many people in Juneau can barely afford housing despite working two or more jobs and maintaining sobriety. However, that mindset looks to assign blame instead of finding workable solutions.

Saying, “That guy’s drunk, I’m sober, why does he get help instead of me?” suggests that there is a moral superiority to being healthy. Most people wouldn’t dream of saying “That guy has cancer, I don’t, so why does he get help?” That’s because the answer is obvious: the cancer patient needs the help.

That mindset also conflates two separate issues: the high cost of Juneau housing with Juneau’s problems with homeless and chronically inebriated people. They are both things the city must face, and there may be some overlap in potential solutions, but they can’t be addressed as one problem.

Of course, there are several things that will need to be worked out before any Housing First facility is built. Where to build the housing and how to fund it are two big ones right off the bat. And, those are questions without easy answers, and the answers may reveal a Housing First option isn’t viable in Juneau.

If Juneau can’t afford or build Housing First, that’s one thing. But it’s a discussion that needs to take place as the city continues to address issues of homelessness and citizens who are chronically inebriated.

The conversation can’t be cut short, or not begun, based on inaccurate viewpoints or bad information. As this topic moves forward, hopefully decisions will be made with open ears and thoughtful consideration.